伊曲康唑治疗COPD合并肺部真菌感染的疗效及其作用机制探讨  

The Efficacy and Mechanism of Itraconazole in the Treatment of COPD Complicated with Pulmonary Fungal Infection

作　　者：侯福建[1] 魏召辉 赵月伟[1] HOU Fujian;WEI Zhaohui;ZHAO Yuewei(Department of Respiratory Medicine,Dingzhou People's Hospital,Dingzhou Hebei 073000)

机构地区：[1]定州市人民医院呼吸内科,河北定州073000

出　　处：《医学临床研究》2024年第6期846-848,852,共4页Journal of Clinical Research

摘　　要：【目的】探讨伊曲康唑治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺部真菌感染的疗效及其可能作用机制。【方法】回顾性分析2019年1月至2021年12月本院收治的80例COPD合并肺部真菌感染患者的临床资料,根据治疗方法不同分为伊曲康唑组(采用伊曲康唑治疗)和氟康唑组(采用氟康唑治疗),每组40例。比较两组住院时间、病死率、不良反应发生率及治疗前后血清肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)。【结果】伊曲康唑组住院时间短于氟康唑组(P<0.05),病死率低于氟康唑组(P<0.05)。治疗前,两组患者血清TNF-α、IFN-γ、IL-1β、IL-2、IL-4、IL-10水平比较,差异无统计学意义(P>0.05);治疗后,伊曲康唑组血清TNF-α、IL-2、IL-4、IL-10水平低于氟康唑组(P<0.05),IFN-γ水平高于氟康唑组(P<0.05);伊曲康唑组不良反应发生率为30.00%,显著低于氟康唑组的37.50%,差异具有统计学意义(P<0.05)。【结论】采用伊曲康唑治疗COPD合并肺部真菌感染患者,临床效果较好,其作用机制可能为调节炎症因子水平。【Objective】To explore the therapeutic effect and possible mechanism of itraconazole in the treatment of chronic obstructive pulmonary disease(COPD)with fungal infection.【Methods】A retrospective analysis was conducted on the clinical data of 80 COPD patients with pulmonary fungal infections admitted to our hospital from January 2019 to December 2021.According to different treatment methods,they were divided into the itraconazole group(treated with itraconazole)and the fluconazole group(treated with fluconazole),with 40 cases in each group.We compared the length of hospital stay,mortality rate,incidence of adverse reactions,and serum levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-2(IL-2),interleukin-4(IL-4),and interleukin-10(IL-10)before and after treatment between two groups.【Results】The hospitalization time of the itraconazole group was shorter than that of the fluconazole group(P<0.05),and the mortality rate was lower than that of the fluconazole group(P<0.05).Before treatment,there was no statistically significant difference in serum levels of TNF-α,IFN-γ,IL-1β,IL-2,IL-4,and IL-10 between the two groups of patients(P>0.05);After treatment,the serum levels of TNF-α,IL-2,IL-4,and IL-10 in the itraconazole group were lower than those in the fluconazole group(P<0.05),and the levels of IFN-γwere higher than those in the fluconazole group(P<0.05);The incidence of adverse reactions in the itraconazole group was 30.00%,significantly lower than the 37.50%in the fluconazole group,and the difference was statistically significant(P<0.05).【Conclusion】The use of itraconazole in the treatment of COPD patients with pulmonary fungal infection has a good clinical effect,and its possible mechanism of action is to regulate the level of inflammatory factors.

关 键 词：肺疾病 慢性阻塞性/并发症 肺疾病 真菌性/并发症 伊曲康唑/药理学 治疗结果 

分 类 号：R563[医药卫生—呼吸系统]